BVHS Weekend Column: Skin Cancer

In the summer, many people look forward to spending time under the energizing sunrays….

Skin Cancer, by Jay Alammar, MD, Surgical Associates of Northwest Ohio

Jay Alammar, MD

The skin is the largest organ of the body, and skin cancer is the most common cancer in the United States regardless of age, race or skin color. The disease incidence is reaching an epidemic level. Over 5.5 million cases of skin cancer are diagnosed each year, and approximately 15,000 people die each year from this disease. The current estimate is that 1 in 5 Americans will develop skin cancer in their lifetime. The US average annual cost of treating skin cancer is about $8 billion. Considering this enormous cost in lives and health care dollars, increasing awareness about prevention, early detection and prompt treatment of skin cancer is crucial.

Skin cancer has two major categories:

  1. This type is the cause for 4 percent of skin cancers, making it the least common. However, it is the most aggressive type and is responsible for the most deaths from skin cancer. 85 percent of melanoma cases are related to exposure the sun UV radiation. 
  2. Non-melanoma. This type causes 95 percent of skin cancers, 90 percent of which are cases related to exposure to UV radiation.

There are two main types of non-melanoma cancers:

  1. Basal cell cancers. These account for 75 percent of cases, and that number is slow growing Fortunately, basal cell cancers are easily treated, and the majority are curable if detected early and never metastasize.  
  2. Squamous cell cancers. These account for 20 percent of cases and are more aggressive than basal cell cancers. Squamous cell cancers could involve lymph nodes and may metastasize if not treated promptly.


Those who have blue or green eyes, red or blond hair, fair skin that freckles or burns easily, a history of sunburns at any age, a history of excessive sun exposure, and/or a history of tanning bed use are at greater risk for skin cancer. Those who possess these risk factors should be diligent in performing a monthly skin self-exam and a yearly clinical exam by a physician, and they should be familiar with the ABCDE of skin cancers.

A= Asymmetry (any irregularly shaped mole)

B= Borders (moles with jagged edges)

C= Color (moles with color variation)

D= Diameter (moles with diameter greater than the third of an inch or 7 mm)

E= Evolution (moles that have changed in size, shape or color)

Knowing the ABCDE of skin cancers may save your life or the life of a loved one. If you or anyone you know has a skin growth that matches any of the above criteria, show it to a primary care provider.

In the summer, many people look forward to spending time under the energizing sunrays. However, please remember that UV light secondary to sun exposure is the greatest modifiable skin cancer risk factor. Seek shade when the sunrays are strong, cover up when there is no shade, always wear sunscreen (greater than SPF 15), wear sunglasses and wide brim hats, do not forget to protect children, and avoid tanning beds and tanning supplements.

Fortunately, skin cancer is one of the most preventable and easiest to treat of all cancers. Raising awareness about the harms of unprotected sun exposure and encouraging sun-safe habits will undoubtedly save many lives. In addition, raising awareness about early detection makes treatment more curative and less disfiguring.

New Heart & Vascular Specialist at BVHS

Blanchard Valley Medical Practices, recently welcomed Peter Rossi, MD to Heart & Vascular Specialists of Northwest Ohio.

Blanchard Valley Medical Practices, a division of Blanchard Valley Health System, recently welcomed Peter Rossi, MD to Heart & Vascular Specialists of Northwest Ohio. The office is located within Blanchard Valley Hospital at 1900 South Main Street, Findlay, and Dr. Rossi is welcoming new patients. He specializes in cardiothoracic and vascular surgery.

Dr. Peter Rossi

Dr. Rossi received his medical degree from Boston University’s School of Medicine (Boston, MA). He completed one residency in general surgery, one residency in chief general surgery and two residencies in cardiothoracic surgery. Dr. Rossi has been a practicing cardiac, vascular and thoracic surgeon since 2002. He is board-certified in general surgery as well as thoracic and cardiac surgery.

Dr. Rossi is joining cardiologists Michael Denike, DO and Pamela Reed, MD as well as the team at Heart & Vascular Specialists of Northwest Ohio. The providers at this practice offer a variety of treatments for patients with heart disorders and diseases.

For more information or to schedule an appointment, call 1.833.20.HEART.

BVHS Screening & Wellness Day

Screening and wellness day event on Saturday, June 22

Community Screening & Wellness Day at The Armes Family Cancer Care Center

 The Armes Family Cancer Care Center, a division of Blanchard Valley Health System, will offer a community screening and wellness day event on Saturday, June 22 from 9 a.m. to 1 p.m. Several health screenings will be offered at this event, which will take place at The Armes Family Cancer Care Center located at 15990 Medical Drive South in Findlay.

Skin, head and neck cancer screenings will be available by appointment only and can be scheduled by calling 419.429.6428.

Screenings available by walk-in include breast cancer, lung cancer, colon cancer, bone density, hereditary cancer risk assessment, and general wellness including glucose and blood pressure checks.

Post-screening, patients will be referred to respective health providers for consultation if necessary. Certain patients may qualify to receive a fecal immunochemical test (FIT) kit after the conclusion of the colon cancer screening for further analysis. Similarly, patients who meet certain criteria may schedule a free mammogram at the conclusion of their breast cancer screening, funded by a grant from Susan G. Komen of Northwest Ohio. Furthermore, lung cancer screenings may result in referral to the Lung Cancer Screening Program if qualified.

Additionally, information regarding smoking cessation, living will and power of attorney preparation, HPV vaccination, cancer prevention, and more will be available.


All individuals are encouraged to receive information on screenings and wellness. Those who have a family history of cancer, use tobacco or alcohol products, do not receive regular dental screenings, or do not receive regular wellness checks from their family physician are especially encouraged to attend. Family physicians can also perform these screenings if individuals cannot attend this special event.


The Armes Family Cancer Care Center provides a full spectrum of cancer care services within a centralized community campus for expert cancer care. To learn more about these services, call 419.423.5522. For questions about this 2019 Community Screening and Wellness Day, choose option five upon calling.

BVHS Event: “Get Heart Smart”

Health fair, screenings, informational booth, drawing, and more…..

Blanchard Valley  Health Systems will be hosting a health fair at Blanchard Valley Hospital with screenings, informational booths, and a panel discussion on Thursday, June 20.

Please RSVP by June 17th. All the details are here:


BVHS Weekend Column: Colon Cancer Screening Methods

There are multiple ways to screen for colorectal cancer…..

Colon Cancer Screening Methods by Brianne Hottinger, RN, Oncology Nurse Navigator, The Armes Family Cancer Care Center
Brianne Hottinger, RN, Oncology Nurse Navigator


Colon cancer is the third most common cancer in men and women in the United States. According to the American Cancer Society, it is estimated there will be over 101,420 new cases of colon cancer and 44,180 new cases of rectal cancer in 2019. The overall lifetime risk for development of colon cancer is about 1 in 22 for men and 1 in 24 for women.

The good news, however, is that the death rate from colorectal cancer has been dropping in recent years largely in part by proper screening. The American Cancer Society recommends screening begins at age 45 and ends at the age of 75 unless encouraged by a physician to extend screening.

There are multiple ways to screen for colorectal cancer. The most efficient screening practice is the colonoscopy. If you choose any other form of screening test and the result is abnormal, it should be followed up with a colonoscopy. Screening measures can be divided into two groups: stool-based tests and visual exams.

Stool-based tests check the stool for signs of cancer. They are less invasive and need to be completed more often than the colonoscopy. The first type of stool-based test is the fecal immunochemical test (FIT). This test can be done in the privacy of your own home and requires a small amount of stool to be collected. There are no dietary restrictions before the test, and collecting the sample can be done quickly and easily. If the FIT kit is positive, meaning that blood is detected in the stool, the patient will be referred for a colonoscopy to look visually for cancer in the colon and rectum.

Another stool-based test is the guaiac-based fecal occult blood test (gFOBT). This test is similar to the FIT in that it looks for blood in the stool. This test can also be completed at home with collected stool, and it allows you to collect more than one sample. As with the FIT kit, if the results are positive, the patient will require a colonoscopy. The gFOBT does have drug and food restrictions that the FIT does not.

Finally, there is a stool DNA test. This test looks for abnormal DNA from cancer or polyp cells. Colorectal cancer often has DNA mutations, and this test will look for those cell changes in the stool. This type of test should be done every three years but will also require a colonoscopy if DNA changes are found in the sample.

The second group of screenings are visual exams, which include CT colography, flexible sigmoidoscopy and colonoscopy. A CT colography takes pictures of the colon and rectum to look for polyps and cancer. Although less invasive, if a polyp or cancer is seen, a colonoscopy will follow to remove it or further screen.

The flexible sigmoidoscopy looks at the entire rectum, but less than half of the colon. This test is not used often due to the reduced amount of colon visualized. Some polyps and cancer may be further along in the colon and will not be detected with this type of visual screening.

Finally, the gold standard of colorectal screening is the colonoscopy. A physician uses a colonoscope to visualize the entire length of the colon and rectum. There is a bowel prep and likely a diet that will need to be followed in the days leading up to the exam. During the colonoscopy, polyps can be removed, and samples can be sent to pathology for diagnosis. If the colonoscopy is clear and there are no abnormal findings, the test will not need to be repeated for 10 years.  

For further information on colorectal cancer screenings, speak with your primary care physician about guidelines and the type of screening that is best for you.

BVHS Weekend Column: Shoulder and Elbow Health Part 2

Warmup is important prior to throwing…..


Shoulder and Elbow Health Part 2, by Craig Hughes, Operations Manager, Julie A. Cole Rehab and Sports Medicine

Craig Hughes

Preventative measures should be taken before an athlete throws to decrease the chances of arm soreness or damage. It is important to keep the arm and shoulder strong by building muscles through strengthening, stretching and exercising. Keeping the muscles mobile and strong will help prevent injury and soreness from occurring, which in turn can improve performance.

As shoulder/elbow endurance and strength are key components in maintaining the overall health of an athletes’ throwing arm, a few areas that are often overlooked include a preseason throwing program, positions the athlete plays in the day(s) following pitching, pitch counts, inning limitations and long toss programs.

Warmup is important prior to throwing. When practice begins and as positions are being determined, the athletes can be asked to throw or make multiple throws at high velocity with minimal preseason training. This can start the initial inflammatory process within the shoulder and elbow.

Most players play multiple positions that may affect their secondary position. This can place additonal stress on the shoulder and elbow due to the increased volume/velocity demands on those joints that are already fatigued from throwing the previous day. For example, a pitcher who is also a catcher or an infielder uses throwing mechancs that can place additional stressors to the shoulder/elbow structures.

The use of pitch counts assists players, coaches and parents in making sure the athlete is not overthrowing while maintaining shoulder/elbow health. Depending on the number of pitches thrown, there is a mandatory rest period once an athlete meets that limit. Many organizations including the Ohio High School Athletic Association (OHSAA), Cal Ripken Baseball, and Pony League have implemented pitch limitations that require a mandatory rest for a set number of days, ranging from zero days of rest for 20 to 30 pitches thrown, to three to four days of rest for 76 to 85 pitches thrown. There are also some limits on the maximum number of pitches that can be thrown on any one day: 50 to 125, depending on the level of play. However, athletes playing multiple contests and/or in mutiple leagues make these pitch counts hard to consistently track. The coach, athlete and/or parent should be involved in tracking the number of throws daily and weekly.  

Inning restriction is more common at younger levels with two innnings being the most a pitcher can pitch in one day if he or she has not met the pitch limits of his or her league. Inning limits in addition to pitch limits should be taken into consideration if a pitcher is struggling to find the “zone.” When struggling to find the zone, athletes may compromise their proper throwing mechanics in an effort to throw strikes, creating undue stress on the throwing arm while becoming frustrated.

Long toss programs consist of a set number of throws from a specific distance, rest times and percentage of velocity. This type of program then increases in distance thrown over a period of time while increasing the number of throws made with increasing velocities. When beginning to throw, the distance, number of throws, age of the athlete and previous experience should all be considered. There are many types of throws that an athlete can perform when they are mature enough to withstand the forces placed on the shoulder and elbow with the correct instruction.

These programs can be started during preseason training or during rehabilitation of an injury to increase arm/throwing strength and frequency to avoid future injuries. While these preventative measures can help maintain shoulder and elbow health, growing athletes have special needs related to throwing and the overall health of growth plates. Age-related game and throwing limitations can be discussed with a coach, therapist or orthopedic provider.






Blanchard Valley Health System to Host ‘HeartSmart’ Presentation

Seating is limited. RSVP is required by Monday, June 17….

Blanchard Valley Health System (BVHS) will host “HeartSmart,” a presentation of the “Live and Learn” series, to educate the community about heart health. This event will be held on Tuesday, June 20 from 10 a.m. to 1 p.m. in the Marathon Auditorium of Blanchard Valley Hospital, located at 1900 South Main Street, Findlay.

The event will begin at 10 a.m. with a health fair featuring informational booths, screenings and more until 11:30 a.m. Boxed lunch will be provided at 11:30 a.m. and a panel discussion will be held from noon to 1 p.m.

The panel will consist of Michael Denike, DO and Pamela Reed, MD, physicians at Heart and Vascular Specialists of Northwest Ohio, a division of BVHS. Daniel Sak, DO, a physician at the Daniel J. and Maria H. Sak Sleep Wellness Center, also a division of BVHS, will moderate the panel.

Drs. Denike and Reed provide cardiovascular care at the Jane & Gary Heminger HeartCare Center located within Blanchard Valley Hospital. The Heminger HeartCare Center offers cardiac care services including prevention and rehabilitation, testing and procedures such as cardiac catheterization, stenting, angioplasty and open-heart surgery. The center also offers emergency cardiac care services as well.

Seating is limited. RSVP is required by Monday, June 17 and can be made by emailing or calling 419.423.5551.

Dr. Denike achieved his bachelor’s degree in movement science (kinesiology) from the University of Michigan (Ann Arbor, MI) and completed his master’s degree at Michigan State University (East Lansing, MI). He is board-certified in cardiology, echocardiography and nuclear cardiology. Dr. Denike is also a member of the BVHS Executive Steering Council as the vice president of medical affairs.


Dr. Reed received her medical degree from Michigan State University. She completed an internal medicine residency, cardiology fellowship and interventional cardiology fellowship at William Beaumont Hospital in Royal Oak, Michigan. She is board-certified in internal medicine, cardiology and interventional cardiology.

Dr. Sak completed medical school at the Michigan State University College of Osteopathic Medicine. He completed his internship at Brentwood Hospital (Warrensville Heights, OH) and his residency at the Grand Rapids Osteopathic Hospital (Grand Rapids, MI). Dr. Sak also completed a fellowship in pulmonary and critical care medicine at Henry Ford Hospital (Detroit, MI).

For more information about the Heminger HeartCare Center, visit

BVHS Weekend Column: Shoulder and Elbow Health– Part 1

Whether you or your loved one play in an organized sport or an informal club, it is important to be mindful of the effects these sports can have on the body…..

Shoulder and Elbow Health Part 1 by James Davidson, MD,
Blanchard Valley Orthopedics & Sports Medicine
Dr. James Davidson

For many people, spring is the beginning of baseball and softball season. Whether you or your loved one play in an organized sport or an informal club, it is important to be mindful of the effects these sports can have on the body. Specifically, sore arms are a common health-related issue baseball and softball players face, especially pitchers.

Throughout the season, players’ throwing arms are placed under a large amount of stress, which causes soreness to occur. While some injuries are a result of the athlete growing, shoulder soreness results from overstressing the muscles as they accelerate/decelerate quickly when the player throws the ball. Some of the injuries associated with throwing athletes can include muscle strains of the rotator cuff and impingement of the rotator cuff, caused by the repetitive nature of throwing, growth plate injuries and shoulder instability. These injuries can be caused by muscle tightness around the shoulder, laxity or looseness of the soft tissues surrounding the shoulder, and/or decreased neuromuscular development that occurs as the player is maturing.

While the forces are occurring at the shoulder, the elbow should not be forgotten, as this joint is also susceptible to those same forces at the shoulder occurring from throwing. This results in compressive forces on the inside and outside of the elbow. Elbow injuries that start with joint stiffness and pain can include ligament or growth plate inflammation characterized by a gradual onset of discomfort during throwing, due to an increase workload in volume or intensity of throwing, decreased velocity or control, and possibly a decrease in grip strength. These sprains/tears if not managed could result in a need for surgery. Growth plate injuries can occur in players starting with pain, clicking, catching or locking felt within the elbow, or possible loss of elbow straightening.   

If a player experiences arm soreness from throwing, a good place to start recovery is rest. Soreness is usually the body’s way of telling you to slow down and allow the healing process to take place. If pain is present but the player continues throwing, the player risks causing damage to his/her arm and may also experience a decrease in performance level. By resting, players are being cautious and listening to their bodies.

Additionally, players should ice their throwing arm for at least 15 minutes but not longer than 20 minutes. This reduces the inflammation of tissues that may be damaged and allows players to recover more quickly. Massaging the arm with a foam roll or tennis ball can also help relax the muscles and decrease recovery time.

Those who enjoy playing baseball or softball do not have to experience restrictions due to sore arms. By taking precautionary measures and time to properly treat the arm after throwing, players can get the most out of their season. Speak with your sport medicine or rehabilitation health care provider for more advice on how to properly care for your throwing shoulder and elbow.  

Look for next week’s article by Craig Hughes, operations manager at Julie A. Cole Rehab & Sports Medicine, to learn more about the preventative measures players can take before throwing to decrease arm soreness and damage.

BVHS CEO/Pres Receives Award

2019 Distinguished Service Award to Scott Malaney

BVHS CEO & President Scott Malaney Receives Ohio Hospital Association’s Award

CEO and President of Blanchard Valley Health System (BVHS) Scott Malaney has been nominated and selected to receive the Ohio Hospital Association’s 2019 James R. Castle Distinguished Service Award. The award honors Malaney as an individual whose professional attainments embody qualities of an outstanding leader and mentor for service to the community.

BVHS CEO Scott Malaney

Malaney will be presented with this award at the Ohio Hospital Association 2019 Annual Meeting & Education Summit on June 4 in Columbus, Ohio.

“On behalf of the more than 3,000 women and men of BVHS, I am very pleased to receive this Distinguished Service Award,” said Malaney. “I hold Jim Castle, for whom the award is named, and last year’s award winner, Phil Ennen, in such high regard. It is a terrific honor to have my name associated with theirs.”

Malaney has been the CEO and president of BVHS since October 2000. In his time at BVHS, Malaney has overseen the building of Donnell Patient Pavilion at Blanchard Valley Hospital, the development of Birchaven Retirement Village and more. Divisions of BVHS have earned numerous awards during his tenure, such as Blanchard Valley Hospital named a “100 Top Hospital” by IBM Watson six times and Birchaven Village named a “Best Nursing Home” by U.S. News & World Report four times.

For more information about Malaney and BVHS, visit

Weekend Column: Hepatitis A– Not the “A” You Want

Hepatitis A is a vaccine-preventable liver disease…..

by Brenda Keller, CNP, Gastroenterology Associates of Northwest Ohio

Outbreaks of hepatitis A are taking place in several states throughout the country, including our neighboring states of Indiana, Kentucky, Michigan and West Virginia. In Ohio, the greater Cincinnati area is leading the state in the number of confirmed hepatitis cases. The Ohio Department of Health (ODH) declared a statewide community outbreak of hepatitis A after observing an increase in cases linked to certain risk factors since the beginning of 2018.

According to statistics provided by the ODH, the following is a summary of the hepatitis A outbreak through March 18, 2019:

  • Number of cases between January 5, 2018 and March 15, 2019: 1,979
  • Age range: 1-84 years
  • Gender: 60 percent male
  • Number of hospitalizations: 1,222 (62 percent)
  • Number of deaths: 7
  • Number of (Ohio) counties with cases: 72 (82 percent)

Hepatitis A is a vaccine-preventable liver disease. The virus usually spreads when a person ingests food or beverages contaminated by the stool of an infected person. This is an example of why handwashing is so important! Hepatitis A can also be spread through close personal contact with an infected person, such as through sexual intercourse.

Symptoms of hepatitis A include fatigue, decreased appetite, abdominal pain, jaundice and clay-colored stools. Hepatitis A can result in an illness that ranges from mild, lasting only a few weeks, to severe, lasting several months. In more severe cases, hospitalization may be required.

Persons at risk for hepatitis A include the following:

  • People with direct contact with individuals infected with the virus
  • Men who have sex with men
  • People who use street drugs (whether they are injected or not)
  • Individuals who are incarcerated
  • Persons who are homeless
  • People who have traveled to other places currently experiencing outbreaks

Individuals who believe they are at high risk for a hepatitis A infection should contact their health care provider or local health department for information about vaccination. People who know they have been exposed to someone with hepatitis A should contact their health care provider or local health department to discuss post-exposure vaccination plans.

The diagnosis of hepatitis A is based on clinical and laboratory criteria. The clinical criteria include an acute illness with any sign or symptom consistent with acute viral hepatitis and either jaundice or elevated AST or ALT levels. The laboratory criteria include a positive IgM antibody to hepatitis A virus (anti-HAV) or nucleic acid amplification test (NAAT) for hepatitis A virus positive (including PCR or genotype testing).

Prompt reporting and treatment is important in curtailing the virus. Eliminating risk factors is the most critical component of avoiding the kind of “A” that nobody wants.






Hanco Achieves EMS Star of Life Award

The team at Hanco EMS will be presented this award at the EMS Star of Life Awards Ceremony on Wednesday, May 22

Hanco EMS, a division of Blanchard Valley Health System, has achieved an EMS Star of Life Award presented by the Ohio Chapter of the American College of Emergency Physicians, the State Board of Emergency Medical, Fire and Transportation Services, and the Ohio Department of Public Safety, Division of Emergency Medical Services.

Congratulations to Hanco

This award honors the exceptional work of Hanco EMS and recognizes its remarkable life-saving efforts and patient care performed during a particular incident.

Hanco EMS was one of nine organizations in Ohio to receive an EMS Star of Life Award this year out of more than 60 applicants.

“The personnel at Hanco EMS strive to deliver the fastest, most reliable and highest quality care possible in all situations,” said Craig Spieker, assistant chief at Hanco EMS. “It is our honor to serve those in need of emergency services.”

The team at Hanco EMS will be presented this award at the EMS Star of Life Awards Ceremony to be held on Wednesday, May 22 in Columbus, Ohio. This ceremony will be available for the public to stream live by visiting on the day of the event, and the recording of the ceremony will be kept on the website for six months.

Hanco EMS provides professional and expedient ambulance services and pre-hospital emergency medical care to individuals in Hancock County. The team responds to 911 calls and offers medical transport between care facilities such as nursing homes and the hospital. In addition, Hanco EMS offers medical care at a variety of community events, and its emergency medical technicians take part in continuous medical education and training.

For more information about Hanco EMS, visit

BVHS: Cancer Care Center Achieves Accreditation

The Armes Family Cancer Care Center Achieves Rating….

The Armes Family Cancer Care Center, a division of Blanchard Valley Health System, has achieved a four-year accreditation for its radiation oncology department by meeting the standards of the American Society for Radiation Oncology (ASTRO) Accreditation Program for Excellence (APEx®).


The Armes Family Cancer Care Center achieved accreditation through APEx® by undergoing a rigorous, voluntary, multi-step process during which its policies and procedures were evaluated using consensus-based standards for radiation oncology practice. This accreditation demonstrates The Armes Family Cancer Care Center’s commitment to high standards of safety and quality and shows that it practices patient-centered care by promoting effective communication, coordinating treatment and engaging patients and their families as partners in care.

“Delivering safe, quality care to our patients is The Armes Family Cancer Care Center’s top priority,” said David Spears, service line director for oncology and outpatient specialty services at Blanchard Valley Health System. “In times of need, patients must have the ability to count on their cancer care providers. We achieved this accreditation not for ourselves, but to assure our patients that they are receiving the most elite radiation oncology care possible.”


“ASTRO commends The Armes Family Cancer Care Center for achieving APEx® accreditation. The center has demonstrated a commitment to providing its patients with safe, high-quality radiation oncology services,” said Paul Harari, MD, FASTRO, chair of the ASTRO Board of Directors.


To learn more about The Armes Family Cancer Care Center, call 419.423.5522.

The Armes Family Cancer Care Center